The American text-book of obstetrics for practitioners and students . found attempting to engage by the head in the su-perior st rait at one time, one child should be retardedwhile the other is artificially extracted. If this isimpossible, the first head should be extracted byforceps, the second be treated in like manner, andthen the trunks should be delivered one after theother. Embryotomy is a last resort, but is scarcelyever necessary. A coiling of the cords (Fig. 87) and their en-tanglement may be a source of difficulty and delay Piq. 87—Entanglement of cordsin unioval twins. It maybe nece
The American text-book of obstetrics for practitioners and students . found attempting to engage by the head in the su-perior st rait at one time, one child should be retardedwhile the other is artificially extracted. If this isimpossible, the first head should be extracted byforceps, the second be treated in like manner, andthen the trunks should be delivered one after theother. Embryotomy is a last resort, but is scarcelyever necessary. A coiling of the cords (Fig. 87) and their en-tanglement may be a source of difficulty and delay Piq. 87—Entanglement of cordsin unioval twins. It maybe necessary to cut one In twins (Winckel). or both cords between ligatures before the children can be delivered. In case one child presents by the head and the other by the feet, bothmay come down together, and the two head- become locked in the pelvicentrance and canal. An efforl may be made to push back the child present-ing by the head. If this succeeds, the child presenting by the breech shouldbe extracted immediately, tor it is in imminent danger from asphyxia. It. 96 AMERICAN TEXT-BOOK OF OBSTETRICS. may be possible with forceps to pull the child presenting by the head past thebody of its fellow presenting by the breech. Failing in these attempts, thechild presenting by the breech will almost surely have died and there will beno pulsation in its cord. It should then be decapitated, whereupon the infantpresenting by the head can be extracted without difficulty by forceps. In any case of twin labor, as soon as the first child is born, and the cord,ligated with a double ligature, is cut, the attendant should immediately inves-tigate the position and presentation of the second child. A neglect of this ruleleads very often to the impaction of an unrecognized shoulder presentation in thesecond child, and its consequent death. If an abnormality is discovered in thepresentation of the second child, it should at once be corrected. Then, after wait-ing perhaps half an hour, the amnioti
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Keywords: ., bookcentury1900, bookdecade1900, booksubjectobstetrics, bookyear1
